Seasonal flu kills 12,000 to 52,000 victims per year in the United States, and ~650,000 worldwide. Bird flu is a variant of influenza that presents a small, but potentially devastating level of threat. Understanding flu and effective prevention against it are key to reducing risk. EMS can play an important role in prevention by making vaccinations accessible, by modeling good health behavior, and by educating the public.

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Flu is a group of viruses that have caused large scale outbreaks of illness for at least 2,000 years.1-3 The Spanish flu pandemic of 1918, which is widely believed to have originated in Europe or China,4-6 sickened and killed millions of people around the world and overwhelmed health systems.7 Organizations like the Red Cross (see Image 1) staffed ambulances and makeshift hospitals to care for victims. The Spanish flu may have played a role in the widespread occurrence of encephalitis lethargica (a rare neurological disorder) that was seen near the end of, and shortly after the pandemic; however, more recent analyses dispute that association.8